Thromboprophylaxis - DVT advice needed

[NinjaKitty]

Sorry to be so needy this week but it looks like its my week for getting important stuff stuff sorted out and kicking butt if need be.

Basically I am off to see the consultant on friday where they want to make a decision about whether they start me on Thromboprophylaxis. For those that don't know here is a definition:

Thromboprophylaxis is the practice of giving small doses of anticoagulant drugs to individuals with an increased risk of venous thrombosis, in situations that further increase the risk.

I.e. it is to help prevent DVT occurring by injecting something like heparin or warfarin to stop blood clots forming. Can't remember what the pregnancy safe one is called. This would involve me giving myself daily injections in the naval.

The registrar suggested that it may be an idea for for me to do this due to my high BMI which means I am at higher risk of DVT in the event of a c section and being immobile.

However I have been feeling for several weeks that the doctors have been pushing me in the direction of an elective c section. But I only want a c section in the event that I need one. The idea of major surgery and the recovery it involves really bothers me. It feels very much like the thromboprophylaxis is part of their birth plan and not mine.

So far my pregnancy has been normal. Every test I have had has been normal, every check on the baby has been normal. My BP is ok. There is no family history of DVT and I have never had a DVT.

I can't see any reason why I shouldn't try for a natural birth. I would be grateful if anyone knows about this stuff. I basically want to know if I'm being stupid by not going down the line they are directing. I would like to hold out for a natural birth.

 

[jojo_2012]

How high does your BMI have to be for them to try and push you to a c-section and thromboprophylaxis?

They'll probably get you to inject clexane into your tummy, not your actual naval, but I personally think if you're able to move about during labour you don't need it, and if you have a section they can give you the clexane afterwards. Not that it'll ever do you much harm. Just seems a weird thing to do.

This is coming from someone who works in clinics with gastro surgeons who insert gastric bands in people with BMIs of 55+. It's just not standard procedure in my hospital.

 

[Princess81]

My friend had severe DVT (hereditory) to the point where she had a pulminary embolism (sp) and nearly died. Anyhoo, she has had 2 natural births - I think she was ill after the second but the fact is she had the DVT already iykwim x

 

[Bunnykins]

Hi hon I have a high bmi (am 22 stone) I had a natural birth so don't be forced into a section on bmi alone, question why don't be forced into anything. I'm also at risk of dvt having had one and 2 pe's previous so have been on fragmin injections through my whole pregnancy and for 6 weeks after, they hurt and are a right pain so question why and if u don't like the answer refuse. They are prob thinking u will be at risk as won't be as active after birth.

 

[Hope81]

you only need that for a c section and in most countries all women get that regardless of their BMI if they have a c section. DVT can be fatal if untreated so most of the hospitals they are very good with DVT prevention. the shots theirself is nth to worry it can be done on your tummy or your arm if you ask them, you get a bruise afterwards but they re not really sth to worry about.
about c section now, the gynecologists apparently may decide for a c section if they decide that you are unfit and you will probably not be able to push efficiently at the final stage. (if ofc no other reason for them to decide a c section like breech etc).
i would say to discuss with your consultant and see why it thinks that a c section is the choice. if its only because he consider you unfit for example you can may ask him to try and go from there?
one more thing to concern is that an epidural is not quite easy for very heavy persons to insert and the doctor may not be able to give you one.
i have very high BMI too, when i was pregnant (mc) doctor told me that a c section is not in discussion unleash there is a different reason for it as i seem pretty fit and able to go through the pushing stage.
i am planning for telling them about clexane regardless a c section or not, especially if epidural is involved i am getting the cleaxane shots even if it a normal labour.